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The document is a report form from the Arizona Department of Health Services for recording significant events in long-term care facilities. It requires detailed information about the event, including the type of incident, notifications made, alleged perpetrator details, and facility investigation findings. The form emphasizes the need for thorough investigations and timely reporting within five days of an event.

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Versions	Form popularity	Fillable & printable
2017	4.8 Satisfied (227 Votes)
2015	4.4 Satisfied (220 Votes)
2012	4.4 Satisfied (214 Votes)

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When should level A incidents be reported to DDD?

ADHS is responsible for a number of programs including licensing and regulation of health care and childcare facilities; disease control; immunization education and promotion; emergency preparedness; emergency medical services; state laboratory; public health statistics; radiation regulatory programs; and vital records

When should an incident report be reported?

Incident reports should be completed immediately after a near miss, unexpected, awareness, or adverse events have occurred. This ensures that the involved individuals or witnesses can recall the details of the occurrence with clarity to fill the report form accurately.

When should serious incidents be reported to the risk manager?

Organizations without a sufficient incident reporting mechanism risk being penalized. In the United States, OSHA requires that employers report fatalities within 8 hours, and severe injuries including in-patient hospitalization, amputation or eye loss within 24 hours.

When should a critical incident be reported to the director of quality assurance and corporate compliance within?

All breaches and data security incidents must be reported to Quality Management within 24 hours. Some breaches are reportable to the State, and Quality Management has strict timelines within which to report these breaches.

What is a reportable incident?

Level A incidents must be reported to DDD within 24 hours of occurrence. This requirement ensures that incidents are promptly addressed to protect participants and improve care quality. Providers are responsible for completing the necessary reporting forms to comply with these regulations.

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What are reportable incidents in assisted living in Arizona?

Intentional infliction of physical harm, injury caused by negligent acts or omissions, unreasonable confinement, and sexual abuse or sexual assault as specified in A.R.S. 46- 451(A)(1).

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When should level A incidents be reported to DDD?

When should an incident report be reported?

When should serious incidents be reported to the risk manager?

When should a critical incident be reported to the director of quality assurance and corporate compliance within?

What is a reportable incident?

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What are reportable incidents in assisted living in Arizona?

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